Every year, over one billion people travel by air and that figure is predicted to double in the next two decades. Air travel is a comfortable and safe means of transport and is accessible to all sectors of the population. The global increase in travel, as well as an increasingly aged population, means that there may be a significant increase in older passengers and those with illness who will wish to travel.

Health professionals may increasingly be asked to assess a patient’s fitness to fly, including both UK nationals planning to travel abroad and visitors from overseas who need to be repatriated following an accident or illness while in the UK. Most patients will be able to fly safely, but some may require additional measures such as in-flight supplementary oxygen. Where necessary, even passengers who require specialist in-flight medical care up to intensive care level can usually be transported by air ambulance, although the cost of this can be prohibitive unless covered by the patient’s medical insurance

These guidelines address the most common issues that may affect a passenger’s fitness to fly. Further advice and guidance is available in the IATA passenger medical clearance guidelines, the Aerospace Medical Association and, if the passenger has made a booking, from the airline medical department (where there is one). The Aviation Health Unit can also be contacted for advice by telephone or email Mon-Fri 0800 to 1600 hours.

Notifying an airline about a patient's condition

It is important to note that although Cabin Crew are trained to render advanced first aid, they are not trained to administer medication. In addition, most airlines will assist passengers to reach the toilet accommodation on the aircraft but cannot render more personal hygiene or nursing care.

The majority of in-flight emergencies occur in situations when an individual's medical condition is unknown to the airline and it is therefore essential that the passenger’s physician sends adequate details well in advance of the flight to the carrier. Most airlines have medical advisors who provide advice and “clear” passengers as fit to fly.

The key information that they require is:

the nature of the individual’s condition and its severity/stability,

medication being taken, and

any pertinent information about mobility.

The clearance can be done by telephone or by formal communication using the MEDIF form, available through travel agents or from the internet, which allows the medical information to be structured in a manner that can be processed by the majority of airlines.

The final decision whether or not to carry a passenger is that of the airline, but the more information that is provided in advance, the more likely it is that a reasonable, evidence based decision can be made.

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